06D0511679 CLIA NUMBER - PEDIATRICS 5280, PC

Laboratory Demographics

  • CLIA Code: 06D0511679
  • Facility Name: PEDIATRICS 5280, PC
  • Facility Address: 9094 E MINERAL AVE, SUITE 120
    CENTENNIAL, CO
    ZIP 80112
  • Facility Phone: 303 779-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JULIE C. DECKERMAN
  • NPI Number: 1629030689
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D0511679
LAB Type Physician Office
Facility Name PEDIATRICS 5280, PC
Street 9094 E MINERAL AVE, SUITE 120
City CENTENNIAL
State CO
ZIP 80112
Phone 303 779-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Physician Office
Lab Director DR. JULIE C. DECKERMAN

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This page was last updated on: 9/29/2025